Clinical Application of Three-Dimensional Printed Donor Kidney Models in Recipient Surgery for Living Donor Kidney Transplantation

Abstract

Introduction

In living donor kidney transplantation, recipient surgery is often performed concurrently with donor nephrectomy, limiting preoperative understanding of graft anatomy before graft arrival. This study evaluated the feasibility, safety, and perceived usefulness of intraoperative application of sterilized three-dimensional (3D) printed donor kidney models for surgical planning.

Methods

Patient-specific 3D kidney models were created from preoperative contrast-enhanced computed tomography using SYNAPSE VINCENT software, printed with a Cara Print 4.0 Pro, and gas sterilized for intraoperative use. Ten consecutive transplants using 3D models (June 2024–July 2025) were compared with the most recent 10 without models (June 2022–May 2024). Surgical outcomes were analyzed, and eight surgeons completed a 5-point Likert scale questionnaire on accuracy, handling, and usefulness.

Results

The models reproduced donor kidney anatomy with reasonable accuracy. Surgeons reported benefits for graft orientation, anastomosis, and graft bed preparation, especially for less-experienced surgeons. Handling was satisfactory, although vessel rigidity was noted. No intraoperative complications, graft damage, or contamination events were attributable to model use, and overall surgical outcomes were comparable between groups.

Conclusions

Intraoperative use of sterilized 3D-printed donor kidney models is feasible, safe, and cost-effective. These models may serve as practical adjuncts for surgical planning, anatomical visualization, and education in living donor kidney transplantation. Further multicenter studies are warranted to validate their broader clinical and educational impact.